Healthcare Provider Details

I. General information

NPI: 1285937276
Provider Name (Legal Business Name): DARSHANA R. KADAKIA MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 S EL CAMINO REAL STE 100
SAN CLEMENTE CA
92672-4279
US

IV. Provider business mailing address

910 S EL CAMINO REAL STE 100
SAN CLEMENTE CA
92672-4279
US

V. Phone/Fax

Practice location:
  • Phone: 949-492-4994
  • Fax: 949-492-4995
Mailing address:
  • Phone: 949-492-4994
  • Fax: 949-492-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DARSHANA R. KADAKIA
Title or Position: CEO/PRESIDENT
Credential: M.D.
Phone: 949-492-4994